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What Does Sleep Apnea Mean

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Ahi What Does It Mean

Apnea- Index measures sleep apnea severity. The is the sum of the number of apneas plus the number of hypopneas that occur, on average, each hour.

Working in collaboration with Dr. William C. Dement, Dr. Guilleminault established the apnea index, which is still in use today to characterize the presence and severity of sleep apnea.

To count in the index apneas and hypopneas, collectively called events, must have a duration of at least 10 seconds.

The AHI, as with the separate Apnea Index and Hypopnea Index, is calculated by dividing the number of events by the number of hours of sleep.

From the rating chart here, we see that an index less that 5 is considered normal. For an Apnea-Hypopnea Index from 5 to 15 denotes mild sleep apnea. Fifteen to 30 is moderate, while a greater than 30 is considered severe.

  • AHI = sum of the number of apneas plus the number of hypopneas occurring, on average, each hour.
  • Apneas and hypopneas, collectively called events, must last at least 10 seconds to count as events.
  • The Apnea-Hypopnea Index is calculated by dividing the number of events by the number of hours of sleep.

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What Are Symptoms Of Obstructive Sleep Apnea

The most common symptom of sleep apnea is . However, not everyone who snores has sleep apnea. Snoring is likely to be a sign of sleep apnea when it is followed by silent breathing pauses and choking or gasping sounds. People with sleep apnea often have daytime sleepiness or fatigue.

Common symptoms of sleep apnea include:

  • Loud or frequent snoring
  • Irritability

Pressure Needs And Adjusting A Cpap

As previously mentioned, there are a number of variables to consider when interpreting the AHI reading. It may not be resolved by simply turning the device’s pressure up or down.

The needed amount of change may also be complicated. For example, someone with a high AHI on a sleep study may not necessarily require a high CPAP pressure to resolve the condition. Anatomy and other factors may have a role. If the device is turned up too high, it may cause central sleep apnea to occur. If the settings are too low, it may not work well enough to resolve the condition.

If the AHI remains elevated, it is time to return to your board-certified sleep specialist for an assessment.

Your provider can interpret the AHI in the context of your baseline sleep study, anatomy, medications, change in health status, and other factors. This person should be the one to adjust your CPAP machine’s settings. Though the settings can be changed by anyone, only your provider can make an informed decision.

If surgery is performed or an oral appliance is fabricated to treat sleep apnea, a test may be repeated to ensure the treatment has been effective in resolving the AHI.

What Are The Complications Of Sleep Apnea

Obstructive sleep apnea can lead to serious complications such as

  • Cardiovascular problems: The sudden decrease in blood oxygen levels that occurs during OSA causes the release of substances in the body that increase blood pressure and strain the . This leads to high blood pressure and increases the risk of heart disease. The more severe the OSA, the higher the risk of coronary artery disease, heart attack, heart failure, arrhythmias , , and sudden death. 
  • Excessive daytime and sleepiness: OSA leads to poor-quality sleep that causes daytime , mood changes, and drowsiness. Patients may have difficulty concentrating. They may find themselves falling asleep while watching television or at work and even while doing important activities such as driving. This increases the risk of work-related and road traffic accidents. Children and young people with OSA may perform poorly in school, have poor attention, have behavioral problems, and fall asleep while studying or in class.
  • Complications with medications and surgery: OSA is also a concern with certain medications like and narcotics and general anesthesia. These medications relax the upper airway and may worsen OSA.
  • Sleep-deprived partners: Loud snoring can disrupt the sleep of another person sharing the room, leading to marital discord.

Other Positive Airway Pressure Breathing Devices

Asian boy wearing Sleep Apnea Diagnostic medical device ...

In addition to CPAP, there are other devices that a sleep specialist may recommend for sleep apnea treatment.

Expiratory positive airway pressure single-use devices fit over the nostrils to help keep the airway open and are smaller, less intrusive than CPAP machines. These may benefit people with mild-to-moderate obstructive sleep apnea.

Bilevel positive airway pressure devices can be used for those who are unable to adapt to using CPAP, or for central sleep apnea sufferers who need assistance for a weak breathing pattern. This device automatically adjusts the pressure while youre sleeping, providing more pressure when you inhale, less when you exhale. Some BiPAP devices also automatically deliver a breath if the mask detects that you havent taken one for a certain number of seconds.

Adaptive servo-ventilation devices can be used for treating central sleep apnea as well as obstructive sleep apnea. The ASV device stores information about your normal breathing pattern and automatically uses airflow pressure to prevent pauses in your breathing while youre asleep.

Mild Sleep Apnea Definition And Symptoms

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The definition of mild sleep apnea is, put in its most basic terms, the least-advanced form of obstructive sleep apnea . But you can probably tell that just from its name. The real questions are: Does mild sleep apnea represent a serious health risk? And what are the symptoms of mild sleep apnea you should look out for?

Because mild sleep apnea means your sleep isnt interrupted as often as with more severe cases of sleep apnea, it can be harder to know if you have it. Nonetheless, people who have even a mild form of sleep apnea should be aware of the symptoms and risks, as well as the steps they can take to treat the condition and prevent it from becoming something more serious.

Apnea Vs Hypopnea Events Per Hour Explained

Sleep. We spend a third of our entire lives sleeping. Yet it’s possible your sleep is hurting your health due to sleep apnea. This article will explain the difference between sleep apnea and hypopnea, along with adverse events per hour that disrupt your sleep and your life. Sleep apnea and hypopnea are treatable, but first it’s best to know what they are and how they affect you. This article will explain an apnea vs hyponea and what events per hour are.

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What It Is Its Risk Factors Its Health Impacts And How It Can Be Treated

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Sleep apnea is a condition marked by abnormal breathing during sleep. People with sleep apnea have multiple extended pauses in breath when they sleep. These temporary breathing lapses cause lower-quality sleep and affect the bodys supply of oxygen, leading to potentially serious health consequences.

Sleep apnea is one of the most common sleep disorders in the United States. It can affect and adults and people of both sexes, although it is more common in men.

Because of sleep apneas prevalence and potential health impact, it is important for people to be aware of what sleep apnea is and to know its types, symptoms, causes, and treatments.

Getting Used To Your Cpap Device

Ease into it. Start by using your CPAP device for short periods. Try wearing it for a half hour or an hour while sitting up in bed watching TV or reading a book. Once youve gotten used to that, try using it lying down or when napping.

Use the ramp setting. Most devices can be programmed to start slowly and gradually increase air pressure. The goal is to be asleep before the machine reaches your prescribed pressure setting. Most people find this makes falling asleep much easier and more comfortable.

Reset the machine if air flow wakes you. If a high-pressure stream of air wakes you up, turn the CPAP device on and off to restart the ramp setting.

High Blood Pressure And Obesity

is extremely common in patients with apnea sleep disorders. In apnea, breathing stops, and blood pressure rises.

That’s one reason why there is such a strong severe sleep apnea association with heart disease, stroke, and congestive heart failure.

A recent article in the sleep journal Sleep and Breathing puts this quite bluntly by saying that “Obstructive sleep apnea increases the risk of coronary events or death from cardiovascular causes.” See Sleep Breath 2010 Jun;14:131-6. Epub 2009 Sep 24.

Another article in The New England Journal of Medicine, November 10, 2005, concluded: “The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause…”

Also note that men who snore have twice the risk factors for high blood pressure.

These heart problems are compounded by the sleep apnea-obesity connection. People who are obese or overweight are more likely candidates for nighttime breathing problems and disorders .

If you or someone you love has all four of the above symptoms, sleep apnea is a very real possibility. Sleep apnea tests at one of the sleep apnea clinics should be something you should seriously consider after discussing things with your doctor.

It could literally change and even save your life. And it’s thebest way to confirm diagnosis and treatment .

If You Are Concerned You Might Have Osa Talk To Your Doctor

Based on your symptoms, exam, and risk factors, your doctor may recommend a sleep study, or you might be referred to see a sleep medicine specialist. A comprehensive sleep assessment is needed to accurately evaluate sleep complaints, since sleep disorders tend to overlap. Treatment for mild OSA may improve sleep-related symptoms and your quality of life. However, there is no one-size-fits-all approach when it comes to sleep disorders, but rather a multidimensional and individualized approach to find what works for you.

What Are The Signs & Symptoms Of Obstructive Sleep Apnea

When breathing stops, oxygen levels in the body drop and carbon dioxide levels rise. This usually triggers the brain to wake us up to breathe. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.

This pattern can repeat itself all night in obstructive sleep apnea. So people who have it don’t reach a deeper, more restful level of sleep.

Signs of obstructive sleep apnea in kids include:

  • snoring, often with pauses, snorts, or gasps
  • heavy breathing while sleeping

Because it’s hard for them to get a good night’s sleep, kids might:

  • have a hard time waking up in the morning
  • be tired or fall asleep during the day
  • have trouble paying attention or be hyperactive

As a result, obstructive sleep apnea can hurt school performance. Teachers and others may think a child has or learning problems.

Complex Sleep Apnea Syndrome Is A Combination Of Osa And Central Sleep Apnea

80% OF SLEEP APNEA cases go undiagnosed! That means every ...

Doctors have recently identified a third type of sleep apnea called complex sleep apnea, which is a combination of obstructive sleep apnea and central sleep apnea.  Patients with this type of sleep apnea may at first seem to have obstructive sleep apnea, but unlike typical patients with obstructive sleep apnea, these patients symptoms are not fully addressed with the use of CPAP.

In patients with complex sleep apnea syndrome, breathing problems persist even after the airway obstruction is addressed and treated, which means something besides the collapsing throat muscles are also contributing to the apnea.

The problem is that there is still a lot of debate among sleep medicine specialists about whatexactly is going on in complex sleep apnea, or what the key characteristics that define it are. 

In a study published in March 2014 in the journal Sleep Medicine Clinics, doctors conducted a review of 223 patients referred to the Mayo Clinic Sleep Disorders Center over one month, as well as 20 patients diagnosed with central sleep apnea. 00122-7/abstract” rel=”nofollow”>11 They found that 15 percent of all sleep apnea patients had complex sleep apnea. As many as 84 percent were found to have obstructive sleep apnea, and 0.4 percent had central sleep apnea.

Why Don’t I Remember Waking Up During An Event

During a sleep apnea event, your body might “wake up” from the deep levels of sleep required to feel rested, but doesn’t wake you up to a conscious level typically.

Hopefully, after reading this article, you now know the difference between apnea vs hypopnea. If you have any questions about some of the terminology, be sure to leave a comment.

How Is Hypopnea Different From Sleep Apnea

Sleep apnea and hypopnea are from the same family of sleep breathing disorders. While a hypopnea is a period of shallow breathing, an apnea is a complete pause in breathing. If someone suffers from a sleep apnea disorder, they may also experience hypopneas. However, people with a hypopnea disorder experience a greater number of hypopneas.

Beyond the difference in breathing, sleep apnea and hypopnea disorders are very similar. They share the same types, symptoms, and risk factors. While apneas are generally considered more severe than hypopneas, there is evidence that both carry similar risk factors for cardiovascular disease and other comorbidities.

What Causes Sleep Apnea

Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses during sleep. Central sleep apnea is usually observed in patients with central nervous system dysfunction, such as following a stroke or in patients with neuromuscular diseases like amyotrophic lateral sclerosis . It is also common in patients with heart failure and other forms of heart, kidney or lung disease.

What Are Risk Factors For Obstructive Sleep Apnea

The major risk factor for sleep apnea is excess body weight. You are much more likely to have sleep apnea if you are overweight or obese. However, sleep apnea can occur in slim people too. Common risk factors for sleep apnea include:

  • Excess weight: Your risk for sleep apnea is higher if you are overweight or obese .
  • Large neck size: Your risk for sleep apnea is higher if you have a neck size of 17 inches or more for men, or 16 inches or more for women. A large neck has more soft tissue that can block your airway during sleep.
  • Middle age: Sleep apnea can occur at any age. However, it is more common between young adulthood and middle age.
  • Male gender: Sleep apnea is more common in men than in women. For women, the risk of sleep apnea increases with menopause.
  • Hypertension: High blood pressure is common in people who have sleep apnea.
  • Sedation: Medication or alcohol can interfere with the ability to awaken from sleep and can lengthen periods of apnea.
  • Airway abnormalities: Examples are a deviated septum or nasal polyps.
  • Family history: You have a higher risk of sleep apnea if a family member also has it. Inherited traits that increase the risk for sleep apnea include obesity and physical features such as a recessed jaw. Other common family factorssuch as physical activity and eating habitsmay play a role.

What Are The Causes Of Sleep Apnea

Obstructive sleep apnea occurs when a persons airway becomes blocked during sleep. Multiple factors have been found to increase the risk of blockage and OSA:

  • Anatomical characteristics. The size and positioning of a persons neck, jaw, tongue, tonsils, and other tissue near the back of the throat can directly affect airflow.
  • Obesity. Being overweight is a leading cause of OSA and may be an underlying risk factor in up to 60% of cases. Obesity contributes to anatomical narrowing of the airway, and research has found that a 10% increase in weight can equate to a six-fold increase in OSA risk.

Related Reading

  • Sleeping on your back. This sleeping position makes it easier for tissue to collapse around the airway and cause blockages.
  • Nasal congestion. People whose ability to breathe through the nose is reduced because of congestion are more likely to experience OSA.
  • Hormone abnormalities. Hormone conditions like and may increase the risk of OSA by causing swelling of tissue near the airway and/or contributing to a persons risk of obesity.

In CSA, breathing is affected in a different way than in OSA. Instead of an obstruction causing breathing lapses, the problem arises in how the brain communicates with the muscles responsible for respiration. In particular, the brain stem fails to adequately perceive the levels of carbon dioxide in the body, leading to breathing that is slower and shallower than it should be.

Oxygen Levels In Pregnant Women

Overweight women who are pregnant or women who gain too much weight during pregnancy are at a higher risk of developing sleep apnea. This can cause a drop in blodd oxygen levels during sleep which can create complications for the baby.

So if you are overweight or gained a lot of weight during pregnancy, speak with your doctor to investigate if you have sleep apnea.

For more info about obesity, see sleep apnea and obesity.

Factors Affecting The Pressure Setting You Need

Your upper airway anatomy and the nature of your airway obstruction play the biggest role in figuring out the required pressure setting. Different amounts of air will be needed if your sleep apnea occurs due to:

  • Deviated septum
  • Tongue falls back into your airway
  • A collapsing soft palate

Also, being obese or overweight could exacerbate things. In fact, when individuals lose around 10 percent body weight, they may need to turn down the CPAP settings.

Medications that relax the muscles of the airway , alcohol and sleeping your back could add to your pressure requirements temporarily.>

REM sleep towards morning could relax your muscles and exacerbate sleep apnea.

What Are The Effects Of Sleep Apnea

Does Snoring Mean You Have Sleep Apnea? : Roberto Palmieri ...

If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy , heart failure, diabetes, obesity and heart attacks.

Its likely that sleep apnea can cause arrhythmias and heart failure because if you have sleep apnea, you tend to have higher blood pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.

This is because sleep apnea can cause:

  • Repeated episodes of oxygen lowering .
  • Changes in carbon dioxide levels.
  • Direct effects on the heart due to pressure changes within the chest.
  • Increased levels of markers of inflammation.

With the high prevalence of sleep apnea in cardiac arrhythmias and heart failure , experts recommend that you dont delay in seeking the advice of your physician.

Last reviewed by a Cleveland Clinic medical professional on 03/03/2020.

References

What Do The Numbers In The Ahi Mean

The AHI is the number of times you have apnea or hypopnea during one night, divided by the hours of .

  • Normal sleep: An AHI of fewer than five events, on average, per hour
  • Mild sleep apnea: An AHI of five to 14 events per hour
  • Moderate sleep apnea: An AHI of 15 to 29 events per hour
  • Severe sleep apnea: An AHI of 30 or more events per hour

Children are less likely to have sleep apnea episodes. Most specialists see an AHI above 1 as unusual for them. A child typically needs treatment if their AHI is higher than 5.

What Is Obstructive Sleep Apnea

There are different types of sleep apnea, including central sleep apnea, and obstructive sleep apnea is the most common. It is a common and serious sleep disorder that causes you to stop breathing during sleep. If you have sleep apnea, your airway becomes blocked repeatedly during sleep. The amount of air reaching your lungs is limited. When this happens, you may snore loudly or make choking noises. Your brain and body become oxygen deprived and you may wake up. This may happen a few times a night, or in more severe cases, several hundred times a night.

In many cases, an apnea, or a short pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in the back of the throat vibrate as you breathe.

If you feel tired or unrefreshed after waking up even though you have had a full night of sleep, it may be due to sleep apnea. During the day, you may feel fatigued, have difficulty concentrating or may even unintentionally fall asleep. This is because your body is waking up numerous times during the night, even though you might not be conscious of each awakening.

The lack of oxygen your body receives can have a negative impact on your health. This includes:

Sleep Apnea Cardiovascular Risk And Metabolism

Several studies have shown an association between sleep apnea and problems like type 2 , , heart attacks and even a shortened lifespan, says Jun. Why this connection? For one thing, obesity is common in sleep apnea patients, and obesity greatly increases risks of diabetes, stroke and heart attack, he says. In most cases, obesity is the main culprit behind both conditions, Jun explains.

Still, its important to note that not everyone with sleep apnea is obese. Furthermore, evidence suggests an independent link between sleep apnea and diabetes. Our lab and others have shown that sleep apnea is associated with higher risks of diabetes, independent of obesity, and that sleep apnea can increase blood sugar levels, says Jun.

For people who are overweight or obese, weight loss is key for treating or avoiding sleep apnea. People who accumulate fat in the neck, tongue and upper belly are especially vulnerable to getting sleep apnea. This weight reduces the diameter of the throat and pushes against the lungs, contributing to airway collapse during sleep.

Women in particular should be careful as they age. While premenopausal women tend to put on weight in the hips and in the lower body instead of the belly, this shifts with time. Weight begins to accumulate in traditionally male areas like the tummy, and this leads to a greater chance of sleep apnea.

What Is A Cpap Device And How Does It Work

A CPAP device is a machine that uses a hose and airtight nosepiece or mask to deliver a steady stream of air as you sleep. The air pressure helps keep your airway open, preventing pauses in breathing.

CPAP technology is constantly being updated and improved, and the new CPAP devices are lighter, quieter, and more comfortable than they used to be. So even if youve given up on them in the past, you owe it to yourself to give them a second look.

Signs And Symptoms Of Sleep Apnea

Family members or bed partners often pick up on the signs of sleep apnea first. Many people with sleep apnea don’t know they’re snoring and gasping for breath at night. If you have any of the following signs, see your doctor:

  • daytime sleepiness
  • loud snoring followed by silent pauses
  • gasping or choking during sleep
  • morning headache
  • poor concentration or memory loss
  • lowered sex drive

Snoring by itself doesn’t necessarily mean that you have sleep apnea. It is true that loud snoring is common in people with this disorder, but there’s a big difference between simple snoring and sleep apnea.

Untreated sleep apnea can cause serious health problems. If it’s not treated, sleep apnea can lead to:

  • high blood pressure
  • work-related injuries

American Sleep Apnea Association

We envision a world in which most people suffering from sleep apnea are diagnosed, aware, educated and treated. This serious syndrome, when left untreated has a large influence on quality of life and multiple life-threatening implications. Yet it is highly treatable. Unfortunately it is estimated that more than 80% of people suffering from sleep apnea are undiagnosed. To help those living with sleep apnea, we work relentlessly to promote

  • better awareness in the general public and among health professionals and,
  • affordable, convenient and highly effective diagnoses and treatments.
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